Bill B

Jeremy made the point earlier (before this meeting) that something else being sold is predictability.  If you go into any Starbucks and you order a particular drink, it will taste the same as this drink ordered at a Starbucks somewhere else.  Jeremy made a very important point that predictability is itself addictive.  Just as the sugar is and the caffeine are addictive. This is a perfect storm. You don’t want to go to Starbucks and order your favorite drink only to find out that it doesn’t taste like it is supposed to taste.  The same with McDonalds and Kentucky Fried Chicken. The predictability that Jeremy mentioned is a very important point. It is in addition to what Jack has mentioned, which is the sugar (along with caffeine).

Jack

We judge people’s moral failures if they are over-weight.  We never judge the manufacturer. This is just like we did for years with Tobacco. We judged the people who smoked and not the tobacco companies. We finally got around that a little bit.  However, we still have some moral judgment in health care about all sorts of things. I think high fructose corn syrup is one of those matters that results in a phenotype we judge to be morally derelict.

Bill G

I was just thinking that we are now coming up with substitute addictions – such as the use of raw cane sugar.

Jeremy

That’s the thing. The alternatives to sugar are proliferating, much like the types of sodas that we drink.  It is getting very hard to tell what the hell is in your drink.  Patients will come and ask what is healthiest.  Maybe it is sugar—but it is not that much healthier. I find that this is getting complex. And the comment around consistency. This observation comes from Lustig’s Metabolical. That is almost a bible on the impact of nutrition on the body. His big focus is on the profiting that comes from processing. It is in over-processing that you tend to extract all of the nutrients from food and concentrate impact on the human being’s need for nutrition.  The human brain interprets the processed food as meeting nutritional needs. This fits with the whole allostatic concept that Peter Sterling has brought up. If I drink a diet soda because it had no calories my brain thinks that I have consumed sugar. Thus, my body makes my pancreas secrete insulin anyway.  So, you don’t really lose weight with these drinks. Your body is providing a perfectly natural biological response based on your brain thinking that you have just consumed some sugar.  So, in anticipation of the sugar your pancreas secretes insulin. It is an anticipatory regulation, not a homeostatic regulation. If I am in an industry that just creates artificial flavor, then I can tell everyone that there are no calories. The mental model is that you can’t get fat unless you consume calories. It turns out that you get fat without calories. You can actually lose weight drinking milk compared to drinking a diet soda.